Ground-breaking telehealth trial helps specialist nurse remotely manage medication changes
A “ground-breaking” telehealth trial has been deployed across West Wales to support people living at home with long-term health conditions.
Hywel Dda Local Health Board is working in partnership with Delta Wellbeing, telecare provider Tunstall Healthcare, and local primary care services to support patients across Carmarthenshire, Ceredigion and Pembrokeshire with long-term conditions – such as cardiac, lung, and chronic disease – at home using pioneering telehealth equipment.
The initiative focuses on supporting wellbeing in the community using remote monitoring and is transforming the way that care services are delivered to people living with long-term conditions.
From a service perspective, telehealth means that patients can remain in their own homes, with the reduced need to travel to appointments and decreasing the need for staff to see patients who can be supported remotely. This in turn reduces stress and expense, and improves the quality of life for patients and their families.
Clare Marshall, a heart failure specialist nurse for Hywel Dda Local Health Board, commented: “Telehealth equipment allows me to manage medication changes from a distance, which patients really like.
“I have been able to prevent hospital admission and more complex care interventions for a patient whose heart rate had decreased following a change of medication.
“Overall, the service empowers patients to manage their own condition as they learn more about what impacts upon their health, and increases confidence in recognising their symptoms. The service builds upon the principles of shared decision making and co-production in healthcare, delivering improved outcomes.”
Commenting on the telehealth trial, Gavin Bashar, Managing Director at Tunstall Healthcare, added: “Long term health conditions account for approximately 50 percent of all GP appointments, and more than 70 percent of all inpatient bed days.
“Using telehealth can help to provide ongoing monitoring to these patients in their own homes, enabling early intervention and empowering them to feel more confident in managing their health.
“Patients in the trial use using telehealth equipment including a blood pressure cuff, weighing scales and a pulse oximeter. The readings from these devices are transmitted to the Tunstall myMobile app on their smartphone and all the information submitted by the patient can be viewed remotely by clinicians 24/7, allowing preventative action to be taken.
“The telehealth service means that changes to a patient’s health or any response to medication can be monitored in real time, ensuring help can be provided at the earliest opportunity. This can lead to a reduction in the need for more complex interventions.
“The service has protected the wellbeing of vulnerable patients, improved outcomes in patients living with long term conditions, enabled the faster discharge of patients from hospital and provided personalised monitoring of complex comorbidities.”
Clinicians use software that provides a dashboard, which prioritises patients that are most in need of care and allows specialist nurses and primary care to remotely monitor each patient’s symptoms and progress. Areas of concern will generate an email or text message to clinicians, enabling them to be addressed promptly.
The technology also allows patients to have consultations by video helping to avoid unnecessary visits to clinics or hospitals. When required, face-to-face appointments will be arranged for further treatment and consultation.
So far around 300 patients have been supported through the service. Early assessment of patient-reported outcome measures show improvement of quality of life and a change in behaviour with improved physical and psychological outcomes.
Speaking on the benefits of home monitoring, 79-year-old cardiac patient Pat said: “My heart nurse asked me if I would try this new technology that they were bringing in. I’ve had absolutely no problems what-so-ever.
“It’s no more difficult than going into a GP surgery. It’s all connected to the iPad I have been given which then goes straight through to the heart clinic. It’s so easy! You can do everything from your own armchair no problem at all.”
The trial follows Delta Wellbeing’s successful CONNECT proactive technology-enabled care (TEC) programme. CONNECT has been acknowledged as an exemplar in the UK, providing a good practice example of working across sectoral boundaries to deliver a radical, person-centred approach to wellbeing, care and support.
CONNECT focused on supporting prevention and wellbeing through a technological and digital approach, and combining bespoke TEC equipment with wellbeing calls, access to a 24/7 community response, and digital support. Delta CONNECT is a pioneering national programme funded under the Welsh Government’s Transformation Fund through the West Wales Care Partnership Board.